Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1976
Spinal tuberculosis treated by antituberculous chemotherapy and radical operation.
Between 1956 and 1968, 208 patients with spinal tuberculosis healed by chemotherapy with and without surgical intervention. Two vertebral bodies were affected in 82 patients, one in 23 cases, more than 4 in 70 patients. Sixty-one patients had neural involvement at the time of admission, 42 of them an incomplete or complete paraplegia. ⋯ Modern treatment begins with triple-drug chemotherapy and bed rest for 3 months. If the response is unsatisfactory, debridement or debridement with spinal fusion is carried out as soon as possible. Anterolateral decompression is applied in cases with paraplegia.
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Clin. Orthop. Relat. Res. · Jul 1976
Case ReportsImmobilization hypercalcemia: a case report and review of the literature.
A 17-year-old girl was immobilized in traction for 3 months and in a spica cast for 6 weeks for fractures of the femur and pelvis. Seven weeks after injury and after her acute renal failure had resolved, serum calcium rose and remained elevated for the duration of her immobilization. ⋯ Only after mobilization did the serum calcium levels return to normal and the symptoms abate. Administration of recently developed medical methods of management of hypercalcemia may have prevented this complication.
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Clin. Orthop. Relat. Res. · May 1976
Case ReportsThe treatment of developmental coxa vara by abduction subtrochanteric and intertrochanteric femoral osteotomy with special reference to the role of adductor tenotomy.
Regardless of the method of fixation, results were good in 84.5 per cent of abduction trochanter osteotomies for developmental coxa vara in 32 hips. Operative treatment is recommended after 18 years of age. ⋯ Unsatisfactory correction was caused more frequently by faulty surgical technique than by bony remodelling. The latter was not seen after the age of 6 years.
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On the basis of a 9-year experience with 231 patients with post-laminectomy and post-spinal fusion stenosis of the lumbar spinal canal, we emphasize the importance of recognizing and adequately decompressing such lesions. In the majority of such patients pain relief has been achieved, but some of the failures can be attributed to technical reasons. ⋯ The indications for fusion however were few and require further investigation and evaluation. The significant failure rate points to the need for continuing research into the causes of low back pain and adequate management programs for the patient with the "multiple operated back" who still has disabling pain and drug dependence.